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Objective:To investigate the risk factors of low-level viremia (LLV) among human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients after combined anti-retroviral therapy (ART), and to provide evidence for reducing the risk of LLV.Methods:It was a cross-sectional observation study that enrolled HIV/AIDS patients with LLV (plasma HIV-1 RNA was 50 to 1 000 copies/mL) receiving ART over one year (LLV group) from January 2019 to December 2020 in Guangzhou Eighth People′s Hospital, Guangzhou Medical University. Contemporaneous patients with ART over one year and successful viral suppression (plasma HIV-1 RNA<50 copies/mL) were randomly selected as the control group (suppression group) with a ratio of 1∶2.5, and the risk factors for LLV were analyzed by unconditional logistic regression.Results:A total of 128 and 297 patients were enrolled in LLV group and the suppression group, respectively.ART durations were 3.62(1.83, 4.89) years and 4.91(2.90, 5.88) years, respectively. Multivariate logistic regression analysis showed that the risk factors associated with LLV included the age of initial ART treatment above 50 years old (odds ratio ( OR)=1.82, 95% confidence interval ( CI) 1.01 to 3.26, P=0.046), the baseline HIV-1 RNA over 1×10 5 copies/mL ( OR=2.18, 95% CI 1.30 to 3.68, P=0.003), using the simplified initial ART regimen ( OR=1.82, 95% CI 1.02 to 3.26, P=0.044), missing medication more than three times per year ( OR=2.49, 95% CI 1.55 to 4.01, P<0.001) and changing regimen during ART ( OR=1.90, 95% CI 1.14 to 3.14, P=0.013), while the duration of ART longer than five years could reduce the risk of LLV ( OR=0.37, 95% CI 0.22 to 0.64, P<0.001). In patients with simplified initial ART regimen, the baseline CD4 + T lymphocyte count of whom with LLV was lower than that of whom with viral suppression, and the difference was statistically significant (94.00 (24.00, 281.00)/μL vs 375.00 (310.00, 435.00)/μL, Z=-2.60, P<0.001). Conclusions:The occurrence of LLV is related to the age of initial ART treatment, the baseline HIV-1 RNA, the initial ART regimen, the medication adherence and the change of ART regimen during ART. Strategies may be beneficial to reducing the risk of LLV for HIV/AIDS patients, such as initiating ART as soon as possible, using simplified regimen as initial regimen with caution in patients with low baseline CD4 + T lymphocyte counts, strengthening compliance education, avoiding unnecessary ART regimen changes.
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Objective:To explore the differences of regulator of G protein signaling 4 (RGS4) gene polymorphisms and methylation between schizophrenia and healthy controls, as well as the association between gene polymorphisms and methylation.Methods:A total of 129 schizophrenia patients and 131 healthy controls from Southen Fujian were enrolled in this study. The peripheral blood DNA of all the subjects was extracted.The three polymorphic loci of RGS4 (rs10759, rs12753561 and rs951436) were amplified, sequenced, and then genotyped. In addition, 32 subjects were randomly selected from the two groups respectively and the gene methylation level of RGS4 was detected by sequencing after bisulfite treatment. SPSS 20.0 software was used for data analysis. The χ2 test and independent sample t-test were used to analyze the difference of gene methylation of RGS4.Two-way ANOVA was used to analyze the association between RGS4 gene polymorphism and methylation. Results:There were three genotypes of AA, AC and CC for rs10759 locus in the subjects of patient group and control group. And the distribution difference of genotypes between the two groups was statistically significant ( χ2=6.431, P=0.040), but there was no significant difference in allele frequency( χ2=1.270, P=0.260). For rs12753561, there were three genotypes of GG, GT and TT, and their distribution of genotypes was significantly different ( χ2=6.217, P=0.045). There was no significant difference for the allele frequency for rs12753561( χ2=0.021, P=0.885). For rs951436, there were three genotypes of AA, AC and CC, and there were no significant difference in genotype distribution and allele frequency distribution between the two groups( χ2=0.008, 0.007, both P>0.05). Methylated CpG sites were found in 26 patients and 27 healthy controls, and these were no significant difference between the two groups( χ2=0.110, P=0.740). There was no significant difference ( t=-0.318, P=0.752) of individual methylation rate (number of methylation sites/10) between schizophrenia patient group (0.24±0.11) and healthy control group (0.26±0.18). There was also no significant difference of methylation rate between male and female in both groups(both P>0.05). Finally, there was no significant difference of individual methylation rate among rs10759, rs12753561 and rs951436 genotypes (all P>0.05). Conclusion:RGS4 rs10759 and rs12753561 genotypes may be involved in schizophrenia, while RGS4 gene methylation has no association with schizophrenia. In addition, RGS4 gene polymorphism has no association with the methylation in the current experimental setting.
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Objective:To evaluate the efficacy and safety of lopinavir/ritonavir (LPV/r) and arbidol in treating patients with coronavirus disease 2019 (COVID-19) in the real world.Methods:The clinical data of 178 patients diagnosed with COVID-19 admitted to Guangzhou Eighth People′s Hospital from January 20 to February 10, 2020 were retrospectively analyzed. According to patient′s antiviral treatment regimens, 178 patients were divided into 4 groups including LPV/r group (59 patients), arbidol group (36 patients), LPV/r plus arbidol combination group (25 patients) and the supportive care group without any antiviral treatment (58 patients). The primary end point was the negative conversion time of nucleic acid of 2019 novel coronavirus (2019-nCoV) by pharyngeal swab.Results:The baseline parameters of 4 groups before treatment was comparable. The negative conversion time of viral nucleic acid was (10.20±3.49), (10.11±4.68), (10.86±4.74), (8.44±3.51) days in LPV/r group, arbidol group, combination group, and supportive care group respectively ( F=2.556, P=0.058). There was also no significant difference in negative conversion rate of 2019-nCoV nucleic acid, the improvement of clinical symptoms, and the improvement of pulmonary infections by CT scan ( P>0.05). However, a statistically significant difference was found in the changing rates from mild/moderate to severe/critical type at day 7 (χ 2=9.311, P=0.017), which were 24%(6/25) in combination group, 16.7%(6/36) in arbidol group, 5.4%(3/56) in LPV/r group and 5.2%(3/58) in supportive care group. Moreover, the incidence of adverse reactions in three antiviral groups was significantly higher than that in supportive care group (χ 2=14.875, P=0.002). Conclusions:Antiviral treatment including LPV/r or arbidol or combination does not shorten the negative conversion time of 2019-nCoV nucleic acid nor improve clinical symptoms. Moreover, these antiviral drugs cause more adverse reactions which should be paid careful attention during the treatment.
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Objective:To analyze the dynamic changes of total HIV-1 DNA in peripheral blood mononuclear cells (PBMC) following highly active antiretroviral therapy (HAART) in HIV-1/HCV co-infected patients.Methods:Thirty patients with HIV-1/HCV co-infection without anti-HCV treatment (co-infected group) and 42 HIV-1 infected patients with initial treatment (mono-infected group) admitted to Guangzhou Eighth People’s Hospital from May 2015 to December 2017 were retrospectively analyzed. The virological and immunological responses of the two groups at 12, 24, 48, 72 and 96 weeks after HAART, the changes of total HIV-1 DNA in PBMC and its relationship with peripheral blood HIV-1 RNA and T lymphocyte subsets were observed. SPSS 22.0 statistical software was used to analyze the data.Results:The plasma HIV-1 virus inhibition rate, CD4 + T cells and CD4 + /CD8 + ratio increased and the total HIV-1 DNA in PBMC decreased in both groups after HAART. The inhibition rate of HIV RNA at week 72 in co-infected group was significantly lower than that in the mono-infected group ( χ2=7.93, P<0.01). Compared with the mono-infected group, the CD4 + T cells at week 12, 24, 72 and 96 after HAART were lower in the co-infected group ( U=313.50, 329.00, 286.00 and 204.50, P<0.05 or <0.01). The CD4 + /CD8 + ratio at week 48 in the co-infected group was lower than that in the mono-infected group ( U=294.50, P<0.05). The total HIV-1 DNA of the co-infected group at baseline and week 12 was lower than that of the mono-infected group ( U=362.00 and 359.00, P<0.01 or <0.05). There was no significant correlation between total HIV-1 DNA in PBMC and HIV-1 RNA or CD4 + /CD8 + ratio in both groups ( P>0.05). There was no correlation between total HIV-1 DNA and CD4 + T cells in HIV-1/HCV co-infected group ( b=-0.001, P>0.05), but it had negative correlation in the mono-infected group ( b=-0.001, P<0.05). Conclusion:Total HIV-1 DNA in PBMC was significantly decreased after HAART in HIV-1/HCV co-infected patients. Co-infected with HCV may delay the decrease of total HIV-1 DNA after HAART in patients with HIV-1 infection.
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OBJECTIVE@#To determine the role of fragile histidine triad (FHIT) and MDM2 in carcinogenesis of oral submucous fibrosis (OSF).@*METHODS@#The expression of FHIT and MDM2 was examined by immunohistochemical S-P method in 44 OSF cases, 15 canceration tissues of OSF, and 10 normal oral mucosa tissues.@*RESULTS@#The expression of FHIT was positive in the normal oral mucosa epithelium. The positive expression of FHIT decreased in the OSF and canceration tissues of the OSF.The rate of FHIT positive expression was significantly lower in canceration tissues of OSF than that of the OSF (P < 0.05). The expression of MDM2 was negative in normal oral mucosa epithelium. The positive expression of MDM2 increased in the OSF and canceration tissues of the OSF, and the rate of MDM2 positive expression was significantly higher in the canceration tissues of OSF than that of the OSF (P < 0.05).@*CONCLUSION@#The loss of FHIT and over-expression of MDM2 may play an important role in the carcinogenesis of OSF.
Subject(s)
Female , Humans , Male , Acid Anhydride Hydrolases , Genetics , Metabolism , Immunohistochemistry , Mouth Mucosa , Metabolism , Mouth Neoplasms , Metabolism , Neoplasm Proteins , Genetics , Metabolism , Oral Submucous Fibrosis , Metabolism , Proto-Oncogene Proteins c-mdm2 , Genetics , MetabolismABSTRACT
Objective To analyze incidence,pathogenesis and treatment of the complications of transvaginal hysterectomy(TVH)collected during past six years,and to discuss the possible methods of prevention.Methods The patients involved in present study were admitted and underwent the transvaginal hysterectomy in the General Hospital of PLA from Jan.2000 to Jun.2006.The data of complications occurred at intra-or post-operation were retrospectively analyzed.Results Among all of the 1990 cases with TVH,complications occurred in 75 cases,the incidence of complication was 3.77%,including 21 cases of bladder injury(1.06%),5 cases of ureter trauma(0.25%),6 cases of rectal injury(0.3%),30 cases of vaginal stump inflammation(1.51%),8 cases of vaginal stump haematoma(0.4%),2 cases of intra-abdominal hemorrhage(0.1%),2 cases of vaginal narrowness(0.1%)and 1 case of intestinal obstruction(0.05%).The bladder injury and vaginal stump inflammation almost toke the two third of total cases.Some complications were got correction by surgery appropriately during or after the operation when injuries were found.Some cases were managed by conservative treatment.All of the patients with complications were healed without any sequelae.The organ injuries occurred more easily in the cases with pelvic adhesion or less movable large uteri,such as the cases with the history of pelvic operation,the endometriosis or the lower segment myoma.Conclusions The organs adjoined to uterus were easily damaged by TVH during the performance of operation,and the corresponding complications are common after the operations.The operator should familiar with the pelvic anatomy,master the skilled surgical techniques and suitably control the indications of the TVH.With the improvement of techniques in TVH and the research of new instrument applied in this procedure,the incidence of complications in TVH would be further reduced.
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Objective To detect the expression of lysyl oxidase (LOX) in pelvic floor tissues and the serum copper ions level of the women with stress urinary incontinence (SUI) for exploring the role of LOX in SUI pathogenesis. Methods The sera of 25 patients with SUI were collected before the operation. The content of serum copper was measured by the technique of atomic absorption spectrum. Meanwhile, 25 patients with similar age but suffering from benign gynecological diseases and undergone total hysterectomy were enrolled as control. Biopsy specimens were obtained from the uterine cardinal sacral ligament of the patients with and without SUI during the operation. The histological structure of pelvic collagen fiber was examined with routine HE staining and Van Gieson (VG) staining. Immunohistochemistry was used to determine the location of LOX. Protein expression of the LOX in pelvic floor tissue was analyzed by Western blotting. Results There was no statistical difference in serum copper content between SUI group and the control group. In the HE and VG staining sections, collagen fiber density of pelvic tissue in SUI group was decreased and fibers were arranged disorderly. Immunohistochemistry showed that LOX was mainly expressed in the cytoplasm of fibroblast. The number of positive cells in pelvic tissues of the patients with SUI was smaller than that in the control group, and the positive signal in SUI group was weaker than that in the control group. The gray degree values of SUI group was obviously lower than that of the control group (P